Active NPI
Troy Williamson
- Physician Assistant
- Los Alamitos, CA
National Provider Identifier
1750166591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA63942
- Practice address
- 3751 Katella Ave
Los Alamitos, CA 90720-3113 - Phone
- (562) 598-1311
- NPI assigned
- Aug 29, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA63942 | CA | Primary |
Addresses
Primary practice location
3751 Katella Ave
Los Alamitos, CA 90720-3113
Mailing address
3449 Watermarke PL
Irvine, CA 92612-5620
Phone (606) 548-0352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63942 | CA | MD | Pharmacist |
| PA63942 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America-California | Current | Accepting new patients | |
| Cep America - California | Current | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- San Francisco, CA
- NPI 1023063542
-
- Emergency Medicine Physician
- Santa Ana, CA
- NPI 1548667843
-
- Emergency Medicine Physician
- Montebello, CA
- NPI 1396971651
-
- Emergency Medicine Physician
- Crescent City, CA
- NPI 1366124364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706313600000",
"number": "1750166591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3449 WATERMARKE PL",
"city": "IRVINE",
"state": "CA",
"postal_code": "926125620",
"telephone_number": "606-548-0352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3751 KATELLA AVE",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907203113",
"telephone_number": "562-598-1311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "TROY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-29",
"last_updated": "2024-01-27",
"certification_date": "2024-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA63942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Alamitos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.